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##  School-Based Sex Education: A New Millennium Update. ERIC Digest.            

For the past several decades, no other topic in American education              has received more scrutiny, or raised more eyebrows in concern, than            school-based sex education (SBSE). Over the years, it has been                  debated in virtually every aspect of American society-from the                  classroom to the boardroom, and from the pulpit to the Supreme                  Court. Despite the rhetoric, actual support for SBSE is stronger                than ever. In a recent poll, 93% of all Americans supported SBSE in             high schools, and 84% supported SBSE in middle/junior high schools.             Similarly, 89% of Americans believe that young people should receive            information about contraception and prevention of STDs, and that                SBSE should focus on how to avoid unintended pregnancies and STDs,              including HIV infection and AIDS (Advocates for Youth, 1999).                   Another recent poll of American parents found that an overwhelming              majority of them supported SBSE. In fact, their support exceeded 90%            in 10 of the 15 topics identified; support for the other topics                 ranged from 76% to 88% (Kaiser Family Foundation, 2000). Such                   unprecedented support should signal a call for action by American               schools. As such, this digest will address the need for SBSE and                identify the most recent curricula that have shown to make a                    positive difference in the lives of American youth. WHY                       SCHOOL-BASED SEX EDUCATION?For more than a generation, the                  United States has struggled with detrimental outcomes related to                adolescent sexual behavior. These behaviors have crossed all                    socioeconomic strata and have challenged clinicians, educators,                 parents, and policymakers alike. The reality of the present                     generation is that the majority of American young people will engage            in sexual risk-taking behavior prior to high school graduation. Data            from the most recent Youth Risk Behavior Survey (YRBS) indicate that            half of all high school students have engaged in sexual intercourse             at some point in their lives, and that percentages rise with                    increasing grade level - 39% among ninth graders to 65% among high              school seniors. One in five students has engaged in sexual                      intercourse with four or more partners during their lifetime (CDC,              2000a; Kann, Kinchen, Williams et al., 2000). Two other sexual                  behaviors are also common among America's youth-oral and anal                   intercourse. Studies to determine the extent to which adolescents               engage in oral sex have found it to be a common practice among                  anywhere from 25% to 80% of the adolescent population (Newcomer &               Udry, 1985; Remez, 2000; Strasburger & Brown, 1991). Anal                       intercourse is the newest trend among adolescent females, and for               some, it functions to preserve their virginity and prevent                      pregnancy. Strasburger and Brown (1991) documented this behavior                among seven percent of an upper middle-class population, and 27%                among an inner city group. A more recent study of                               adolescent "virgins" found that one percent had participated in anal            intercourse (Schuster, Bell, & Kanouse, 1996). Disturbingly, an                 increasing number of young people believe that neither oral nor anal            intercourse are "really sex." 
Clearly, the sexual behaviors                   identified above place American youth at great risk for a multitude             of negative health outcomes. Despite steady declines since 1991,                approximately 9% of females between the ages of 15-19 become                    pregnant each year (Henshaw, 2001). In addition to the high risk of             pregnancy, sexually active adolescents in the U.S. risk acquiring               one or more sexually transmitted diseases (STDs). Every year,                   approximately three million American adolescents acquire an STD.                This represents the highest rate of infection among all age groups              nationally and in all industrialized nations worldwide (Piot &                  Islam, 1994). Of all the negative outcomes associated with                      adolescent sexual behavior, none poses a greater threat to the                  health of American youth than HIV infection and AIDS.  Each year,               20,000 young people between the ages of 13-25 are infected with HIV.            As of this writing, there is no cure for HIV infection.  Since the              1980s, more than 400,000 Americans have succumbed to AIDS-related               illnesses (CDC, 2000a). The behaviors and outcomes identified above             provide compelling evidence for school-based sex education. SBSE              IN THE NEW MILLENNIUMOver the course of the past several                    decades, school-based sex education has made a number of positive,              well-documented advances. Gone are the days when most American                  schools chose not to address some or many aspects of sex education.             Today, 82% of high schools, 76% of middle/junior high schools, and              57% of elementary schools require sex education on their                        campuses (Kann, Brener & Allensworth, 2001). 
School-based sex                 education curricula have also made tremendous strides in their                  evolution. Today, SBSE curricula are grounded in science and                    psychosocial theory and have been rigorously evaluated for                      effectiveness. Each of the following curricula has been identified              by the Centers for Disease Control and Prevention (CDC) as having               strong evidence of success - Reducing the Risk; Safer Choices;                  Becoming a Responsible Teen (BART); Making a Difference: An                     Abstinence Approach to STD, Teen Pregnancy & HIV/AIDS Prevention;               and Making A Difference: A Safer Sex Approach to STD, Teen                      Pregnancy & HIV/AIDS Prevention (Kirby, 2001). Each of these                    curricula has been tested with a diversity of youth populations in a            variety of school and community settings. Detailed descriptions and             outcomes can be found at                                                        www.cdc.gov/nccdphp/dash/rtc. 
CHARACTERISTICS OF EFFECTIVE SBSE               CURRICULA & PROGRAMS

Within the last decade, researchers have                identified specific characteristics that make prevention programs               effective. In a recent comprehensive review, Kirby (2001) noted that            effective pregnancy/HIV/STD prevention curricula possess the                    following characteristics. Curricula that lack one or more of these             characteristics are less likely to bring about desired behavioral               effects: 
*  Focus on reducing one or more sexual behaviors that               lead to unintended pregnancy or HIV/STD infection; 
*  Are based on            theoretical approaches that have been demonstrated to be effective              in influencing other health-risk behaviors; 
*  Give a clear                   message about sexual activity and condom/contraceptive use and                  continually reinforce that message; 
*  Provide basic information              about the risks of adolescent sexual behavior and about methods of              avoiding  intercourse or using protection against pregnancy and                 STDs; 
*  Include activities that address social pressures that                influence sexual behavior; 
*  Provide modeling of and practice                with communication, negotiation, and refusal skills; 
*  Employ a              variety of teaching methods designed to involve the participants and            have them personalize the information; 
*  Incorporate behavioral              goals, teaching methods, and materials that are appropriate to the              age, sexual experience and culture of the students; 
*  Last a                 sufficient amount of time to complete important activities                      adequately; and 
*  Select teachers or peer leaders who believe in             the program they are implementing and then provide them with                    training. ABSTINENCE-ONLY CURRICULAThe                                    abstinence-only-until-marriage movement has gained momentum in                  recent years, and has been supported further by a 1996 Congressional            Act that allocated $250 million over five years (1998-2002) to fund             state programs providing abstinence education. The Act defines                  abstinence education as the teaching of benefits of abstinence in               terms of social, psychological, and health gains, as well as the                potential harmful consequences of sexual activity and childbearing              outside of the context of marriage (Thomas, 2000).  A recent poll               found that 70% of Americans oppose the provision of federal funds               for abstinence-only curricula that prohibit teaching about the use              of condoms and contraception for the prevention of unintended                   pregnancy and HIV/STD infection (Advocates for Youth, 1999).  Still,            as a result of this Act, several abstinence-only curricula have                 emerged and are being used nationwide. 
In his recent review of                programs that reduce teen pregnancy, Kirby (2001) noted that few                evaluations of abstinence-only programs have taken place.  Only                 three studies were included in his review, and no conclusions could             be drawn from these studies.  Other evaluations of abstinence-only              curricula have shown that they do not meet professional standards               for comprehensive sex education curricula and they fail to bring                about the desired effects of a delay or reduction of sexual                     intercourse or the use of contraceptives (Advocates for Youth, 2001;            Goodson & Edmundson, 1994). It is expected that a government study              of federally funded abstinence-only programs will be completed by               2002, which should provide more conclusive evidence about the                   effectiveness of these programs. 
IMPLICATIONS FOR THE 21ST                    CENTURY 
Schools and communities must acknowledge that the majority            of American young people will be sexually active prior to their high            school graduation. Accordingly, schools and communities must respond            proactively by providing students with the comprehensive sex                    education curricula they need to prevent the detrimental outcomes of            their sexual behavior. Denial that young people are sexually active,            or failure to provide scientifically validated curricula, may                   jeopardize the future of this generation and those that succeed                 it. REFERENCESAdvocates for Youth. (2001). What's wrong with              federal abstinence-only-until marriage requirements? Transitions,               12(3). Available online at www.advocatesforyouth.org 
Advocates for            Youth. (1999, June 2). Public support for sexuality education                   reaches highest level. Press Conference, Washington DC. Available               online at www.advocatesforyouth.org 
Centers for Disease Control               and Prevention. (2000a). HIV/AIDS surveillance report, year-end                 edition, 1999, 11(2). 
Centers for Disease Control and                         Prevention. (2000b). Young people at risk: HIV/AIDS among America's             youth. Atlanta, GA: Author. 
Goodson, P & Edmundson, E. (1994). The            problematic promotion of abstinence: an overview of sex respect.                Journal of School Health, 64(5), 205-210. 
Henshaw, S.K. (2001).               U.S. Teenage Pregnancy Statistics.  New York:  Alan Guttmacher                  Institute. 
Kaiser Family Foundation. (2000). Sex education in                 America. Menlo Park, CA: Henry J. Kaiser Family Foundation.                     www.kff.org 
Kann, L., Brener, N.D., & Allensworth, D.D. (2001).               Health educaion:  Results from the School Health Policies and                   Programs Study 2000.  Journal of School Health, 71(7),                          266-278. 
Kann, L., Kinchen, S. A., Williams, B. L., et al. (2000).            YRBS surveillance-United States, 1999. Journal of School Health,                70(7), 271-285. 
Kirby, D. (2001). Emerging answers: Research                  findings on programs to reduce teen pregnancy.  Washington, DC:                 National Campaign to Prevent Teen Pregnancy.                                    www.teenpregnancy.org 
Newcomer, S. & Udry, J. (1985). Oral sex in             an adolescent population. Archives of Sexual Behavior, 14,                      41-46. 
Office of National AIDS Policy. (2000). Youth and HIV/AIDS             2000: A new American agenda. Washington, DC: Author. 
Piot, P. &               Islam, M. Q. (1994). STDs in the 1990s: Global epidemiology and                 challenges for control. Sexually Transmitted Diseases, 21(2):                   S7-S13. 
Remez, L. (2000).  Oral sex among adolescents:  Is it sex             or is it abstinence?  Family Planning Perspectives, 32(6),                      298-304. 
Schuster, M. A., Bell, R. M., & Kanouse, D. G. (1996).               The sexual practices of adolescent virgins: Genital sexual                      activities of high school students who have never had vaginal                   intercourse. American Journal of Public Health, 86(11)                          1570-1576. 
Strasburger, V. C. & Brown, R. T. (1991). Adolescent               medicine: A practical guide. Boston, MA: Little Brown. 
Thomas, M.             H. (2000). Abstinence-based programs for prevention of adolescent               pregnancy: A review. Journal of Adolescent Health, 26(1), 5-17.                 ADDITIONAL RESOURCES 
Sexuality Information and Education Council              of the U.S. (SIECUS), 130 West 42nd Street, Suite 350. New York, NY             10036. 
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This project has been funded at least in part with             Federal funds from the U.S. Department of Education, Office of                  Educational Research and Improvement, under contract number                     ED-99-COO-0007.  The content of this publication does not                       necessarily reflect the views of or policies of the U.S. Department             of Education nor does mention of trade names, commercial products,              or organizations imply endorsement by the U.S. Government.                   **Title:** School-Based Sex Education: A New Millennium Update. ERIC Digest.            **Document Type:** Information Analyses---ERIC Information Analysis Products (IAPs) (071); Information Analyses---ERIC Digests (Selected) in Full Text (073); **Available From:** ERIC Clearinghouse on Teaching and Teacher Education, American                  Association of Colleges for Teacher Education, 1307 New York Ave.,              N.W., Suite 300, Washington, DC 20005-4701. Tel: 202-293-2450; Tel:             800-822-9229 (Toll Free); e-mail: [email protected]. For full text:               http://www.ericsp.org.                                                       **Descriptors:** Adolescents, Comprehensive School Health Education, Health                      Promotion, Secondary Education,  Sex Education, Sexuality                    **Identifiers:** Abstinence, ERIC Digests, Sexually Transmitted Diseases                      
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